Hauora Māori /
Māori Health

Introducing This Page

This page informs you about the Māori Health services the West Coast District offers to Māori people.

Māori Language Week 2010

Māori Language Week takes place from 26 July through to 1 August 2010. The theme is "Te Mahi Kai" - The Language of Food.

Please feel free to use the links provided below to download and use the offered resources either to learn more about "The language of food" or to learn frequently used words and phrases in Māori.

The Language of Food

• Food Theme [pdf, size: 100 KB]

Māori Language Resources

• Words and Pronunciations [pdf, size: 13 KB]
• Essential Phrases [pdf, size: 12 KB]
• Words at work and around the hospital [pdf, size: 72 KB]
• The Face [pdf, size: 110 KB]
• The Skeleton [pdf, size: 70 KB]
• West Coast (Southland, NZ) Map [pdf, size: 78 KB]

Improving health outcomes for Māori

Enabling Māori to participate in and contribute towards strategies for Māori health improvement

The most important need to be met by this service is the improvement of Māori health status in Te Tai o Poutini and the achievement of whānau ora by the West Coast District Health Board (West Coast DHB).

DHBs have a responsibility to assist the Crown in fulfilling its obligations under the Treaty of Waitangi and are guided in that responsibility by the New Zealand Health and Disability Act 2000 (NZHD Act) and other policy directions from the Crown.

The Act requires that DHBs take active steps to reduce health disparities by improving health outcomes for Māori. In this responsibility, DHBs must establish and maintain processes that enable Māori to participate in and contribute towards strategies for Māori health improvement. This recognises and respects the principles of the Treaty of Waitangi.

The provision of this service is guided by Hē Korowai Ōranga; 2002 Māori Health Strategy and Whakatātaka Māori Health Action Plan 2002-2005 as directed by the Ministry of Health.

There is also a continuation of that plan called Whakatātaka Tuarua: Māori Health Action Plan 2006-2011.

Reducing Inequalities

We all have a role to play in reducing inequalities in health in New Zealand. Regardless of how we measure health we find that particular groups are consistently disadvantaged in regard to health. And these inequalities affect us all.

Health inequalities or health inequities (the terms are used interchangeably) are avoidable, unnecessary and unjust differences in the health of groups of people. Reducing health inequalities is greatly assisted by tools that enable the assessment of interventions such as policies, programmes and services. Such tools examine the potential of these interventions to contribute to reducing health inequalities. From such an assessment, informed decisions can be made about how to build and strengthen policies, programmes and services.

The Health Equity Assessment Tool: A User's Guide is designed to facilitate the use of one such tool: the Health Equity Assessment Tool (HEAT). HEAT aims to promote equity in health in New Zealand.

• Health Equity Assessment Tool (HEAT)
   (PDF document, size: 9 KB)
• Health Equity Assessment Tool: A User's Guide
   (PDF document, size: 355 KB)

TE TAI O POUTINI MAORI HEALTH PROFILE
Te Tai O Poutini Maori Health Needs Assessment

Health needs assessment is a process of assessing the health and disability needs of a population, including those who do not access services. It is defined by Coster (2000) as: “assessment of the population’s capacity to benefit from health care services prioritised according to effectiveness, including cost-effectiveness, and funded within available resources.”

There are a number of approaches to health needs assessment. More comprehensive approaches usually involve, in the initial stages, description of the population and of its health and disability status. Subsequent stages include the assessment of the current health and disability service providers, including utilisation data, and the seeking of community and provider views on services.

The hope is that the information presented will assist in some way in achieving healthy outcomes for the people. If the consensus is that there is much knowledge and benefit to be gained from the report – grasp it and use it for the betterment of the community.

• Te Tai O Poutini Maori Health Needs Assessment
   (PDF document, size: 806 KB)

The Māori Health Department

The Māori Health Department is the centre point of Māori health development, provides Māori cultural support to staff, and monitors Māori health gain within West Coast DHB funded services. The employment of a General Manager (GM) Māori Health has been significant in advancing Māori health developments including the development and implementation of the WCDHB Māori Health Plan 2003-2006 , WCDHB Māori Health Plan 2007-2011, and ongoing refinement of the District Annual Plan and the District Strategic Plan

The Māori Health Department is not a separate or parallel department; it functions bi-culturally and is jointly supported by the West Coast DHB and Tatau Pounamu Manawhenua Health Group / Māori Heath Advisory Committee. With the guidance and support of Tatau Pounamu Manawhenua Health Group, a strengthening and merging of Māori health interests is occurring.

Rata Te Awhina Trust

Also funded by the West Coast DHB is Rata Te Awhina Trust (the only Māori health provider on the West Coast).

Rata have been operational in the West Coast region for over a decade to provide health services to Māori / non-Māori within a community setting.

Te Herenga Hauora o Te Waka o Aoraki

Te Herenga Hauora o Te Waka o Aoraki is the South Island District Health Board Māori Managers Network.

Established in 2001, their purpose is to provide a forum for mutual support and development of common vision, purpose and strategic directions that continue the momentum for improved Māori health outcomes, effective Māori participation, and influence in the health sector, locally, regionally and nationally.

The Māori Health Advisory Committee

About Tatau Pounamu Manawhenua Health Group

Tatau Pounamu Manawhenua Health Group are the Manawhenua health advisors who are mandated by the Papatipu Runanga: Te Runanga o Makaawhio and Te Runanga o Ngati Waewae as the Treaty of Waitangi partners to the WCDHB. Also included in this forum is Nga Mata Waka o Te Tai o Poutini .

• Tatau Pounamu Manawhenua Health Group Terms of Reference
   (PDF document, size: 146 KB)

Memorandum of Understanding between Poutini Ngai Tahu and the West Coast District Health Board

Discussions between the West Coast DHB and Tatau Pounamu Manawhenua Health Group resulted in the completion and signing of a Memorandum of Understanding (MOU) between the West Coast District Health Board and Poutini Ngai Tahu.

The MOU sets guidelines and articulates principles for an ongoing collaborative relationship that is consistent with the philosophy of the New Zealand Public Health and Disability Act 2000 and takes into account the importance of mutual respect with regard to cultural values and principles.

• Memorandum of Understanding between Poutini Ngai Tahu and the West Coast District Health Board
   (PDF document, size: 207 KB)

The Vision

Tatau Pounamu Manawhenua Health Group Terms of Reference (TOR) outline the purpose and function of the partnership. The vision of the partnership is to improve health outcomes using the principles of the Treaty of Waitangi:

• Partnership
• Participation
• Protection.

Functions of Tatau Pounamu Manawhenua Health Group

The functions of Tatau Pounamu Manawhenua Health Group are to work with the West Coast DHB to:

1. Develop and implement strategies for Māori health gain
2. Provide health and disability support services consistent with Māori cultural concepts, values and practices
3. Support Māori aspirations for health and to reduce inequalities between Māori and that of other New Zealanders for whānau, hapū, iwi and Māori communities

Tatau Pounamu Manawhenua Health Group Māori Health Advisory Committee members

Richard Wallace (Chairperson)	Te Runanga O Makaawhio
Marie Mahuika-Forsyth	Te Runanga O Makaawhio
Ben Hutana	Te Runanga O Ngati Waewae
Tania Pu	Te Runanga O Ngati Waewae
Rehia McDonald	Nga Maata Waka O Kawatiri
George Nathan	Nga Maata Waka O Mawhera

More Background about Tatau Pounamu Manawhenua Health Group

On the 1 July 2005, we were informed by local Runanga that a new Iwi Health Advisory Group named ‘Tatau Pounamu’ was to be established.  This forum was to consist of two members from Te Runanga o Makaawhio and Te Runanga o Ngati Waewae, as well as two members from the Maata Waka community. The WCDHB assisted in organising hui around the West Coast with Māori communities to find Maata Waka representation within this new advisory group.  There are now two Nga Maata Waka representatives on Tatau Pounamu; Nga Maata Waka o Kawatiri (Westport) and Nga Maata Waka o Mawhera (Greymouth).

The WCDHB continues to meet regularly with Tatau Pounamu Manawhenua Health Group on a 6-weekly basis. The General Manager Māori Health, Chief Executive, and GM Planning and Funding continue to work closely with Tatau Pounamu Manawhenua Health Group.

Contact Us

To make contact with Tatau Pounamu Manawhenua Health Group / Māori Health Advisory Committee; in the first instance please contact:

Gary Coghlan
General Manager Māori Health
West Coast District Health Board
PO Box 387
Greymouth 7840
Phone: 03-768-0499, Extn. 2802#
Mobile: 027 458 1745
Email:

Other relevant contacts

Te Runanga O Makaawhio
99 Revell Street
PO Box 225
HOKITIKA 7842
Phone: (03) 755-6010 or (03) 755-7885
Fax: (03) 755-6885
Email:

Te Runanga O Ngati Waewae
1st/49 Tancred Street
PO Box 37
HOKITIKA 7842
Phone: (03) 756-8088
Email: 

Nga Maata Waka o Te Tai o Poutini
PO Box 181
HOKITIKA 7842
Phone: (03) 755-6634
Email: 

Tumu Whakarae

National Reference Group of Māori Managers within DHBs

Kaupapa	The Kaupapa of Tumu Whakarae is to bring together the collective experience of members to further a shared goal that Mäori health gain stays on the national agenda and that as a national Roopū we can provide some of the required leadership.
Specific Purpose	To influence and support the MOH in relation to the direction of Māori strategic directions To influence health policy at national level To influence the DHBs nationally To work in conjunction with DHBNZ To network and support each other (whakawhānaungatanga)
Te Ingoa	The Short name of this Roopu is Tumu Whakarae, which refers to the Pillar of Leadership that we each are required to provide to member District Health Boards, in respect to Māori health strategy across all sectors of health. The Long name of this Roopu is the National Reference Group of Māori Health Managers within DHBs
Members	Each DHB may have at least 1 representative in Tumu Whakarae.  The optimal number of members for the Roopu is 21, one for each DHB in Aotearoa.  Where DHBs have Managers of Māori Health in both the funder and provider functions, then both may be members.  It is vital that all members need to be up to date on the strategic issues affecting Māori health within their DHB.
Representation	Each DHB member is essentially the Kaiwhakahaere, or Co-ordinator, or Manager, or General Manager who advises the CEO and the DHB on matters to do with Māori Health Strategy and/or the implementation of the DHB/health sector changes.  Exceptions should be agreed by a majority vote.

To make contact with Tumu Whakarae / National Reference Group of Māori Managers within DHBs, in the first instance please contact

Gary Coghlan
General Manager Māori Health
PO Box 387
Greymouth 7840
Phone: 03-768-0499, Extn. 2802#
Mobile: 027 458 1745
Email:

MĀORI WORKFORCE DEVELOPMENT

Our Responsibility

The West Coast DHB is committed to its responsibility to provide, maintain, and encourage bicultural staff training to improve the quality, effectiveness, and delivery of health services to Māori. Effective health and disability services are coordinated around the needs and values of whānau, hapū, iwi, and Māori communities, and incorporates Māori cultural values, beliefs and practices

Our vision for Māori workforce development

“A strong, comprehensive and skilled Māori-led health and disability workforce in Te Waipounamu over the next 10 to 15 years.”

Objective: Skill Improvement of the Māori Health and Disability Workforce

An objective of the WCDHB Māori Workforce Development Plan 2003-2009 is to increase the number and improve the skills of the Māori health and disability workforce. It has been identified that Māori workers in health and disability are disproportionate to the New Zealand population particularly in registered professions (all residing largely in community and or support functions).

Strategies

This vision will be achieved through four key strategies

• Information and planning: Developing good Māori health and disability workforce information frameworks and research in Te Waipounamu to inform planning.
• Forming effective relationships: coordinating relationships, roles and responsibilities of key stakeholders with a view.
• Building strategic capacity: setting priorities and initiatives for building workforce capacity in the sector that will improve Māori health.
• Promoting health careers: undertaking activities that attract more Māori into a health career.

Targeted groups

Intersecting the four strategic directions are four key targeted groups where specific strategies need to be applied.

• Māori students in school
• Māori second chance learners
• Māori in the workforce
• The non-Māori health workforce

An objective of the National Māori Workforce Development Plan 2003-2008: Raranga Tupuake is aimed at providing overall direction to avoid duplication within DHB’s.

The Te Waipounamu Māori Workforce Development Plan 2005-2010 is a combination of the overall regional goals and objectives of Māori health workforce development in the West Coast region.

As part of our workforce development strategy...

The following is to provide information about programmes, services, and options available that will assist WCDHB health workforce to improve and enhance their knowledge regarding:

• Tikanga Māori/Māori protocols, customs and values
• How to access the various cultural training programmes available
• Scholarship information
• Assistance/funding for clinical training programmes

KIA ORA HAUORA

Kia Ora Hauora is an innovative new Maori health workforce development programme designed to recruit 1,000 Maori into health career pathways by 30 June 2012.

Kia Ora Hauora is for:

• Maori who are currently studying at secondary level
• Maori who are studying at tertiary level
• Maori who are in work and considering a career change
• Maori communities – whanau, hapu, iwi

Kia Ora Hauora will:

• Identify the health career pathways they should take
• Overcome real and perceived barriers to study, graduation and entry into the health workforce
• Capitalise on education and training opportunities
• Capitalise on financial and mentoring opportunities

Kia Ora Hauora presents a website with a comprehensive scholarship database, national communications activities, and toolkits for partner schools with information about health career educational requirements for each career pathway.

For more information please visit: www.kiaorahauora.co.nz

Cultural Training Programmes

Treaty of Waitangi Workshop

The Treaty of Waitangi Workshop* is a one-day course designed to provide staff with information about the historic events that occurred before and after the signing of the Treaty of Waitangi in relation to Māori health. This workshop is facilitated by the Tai Poutini Polytechnic Chairman and General Manager Māori Health and is delivered to staff in an interactive style.

Course content includes

• The relevance of the Treaty today
• The years before the Treaty
• Treaty texts and meanings
• Post Treaty and Māori development
• Living and valuing other cultures in a partnership environment

*Denotes mandatory/compulsory training for all WCDHB staff

Treaty of Waitangi Training Workshop Dates, Times and Venues 2010
(PDF format, size: 48 KB)

Te Pikorua Bi-cultural Training

Te Pikorua Bi-cultural Training translated means ‘A traditional Māori taonga (treasure) of friendship and growth that depicts two new shoots growing together; the meeting of cultures.’ This cultural training package is a one-day training programme made up of three workshops taught in a kaupapa Māori learning style environment.

The content of these workshops is

• Te Ao Māori
• Tikanga Best Practice
• Responsiveness to Tangata Whenua

The intention of these workshops is to enable staff...

• To gain an understanding of Māori Health
• To gain a better knowledge and understanding of Māori views, values and customs
• To gain a clearer understanding of the cultural needs of Māori patients and their whānau within a clinical environment

Te Pikorua Training Dates, Times and Venues

Te Pikorua Training Workshop Dates, Times and Venues 2010
(PDF format, size: 53 KB)

Inequalities Training

In 1999 the government announced its Reducing Inequalities initiative. This initiative gives priority to reducing disparities in social and economic outcomes – including health outcomes – for disadvantaged New Zealanders. Reducing Inequalities in Health proposes principles that should be applied to whatever activities we undertake in the health sector to ensure that those activities help to overcome health inequalities.

In June 2001, the report Indicators of Inequality was released to assist in the development and competency of this initiative by providing a classification for health indicators and criteria for their selection.

A final report on health inequalities awareness workshops for the health sector was published by the Ministry of Health in June 2004. The Tackling Inequalities: Moving Theory into Action discusses health inequalities awareness training programmes for the health sector

An Inequalities package has been developed by the Planning and Funding Team with assistance from the GM Māori Health. Inequalities Training sessions have been delivered to the Disability Support Advisory Committee, Community and Public Health Advisory Committee, Hospital Advisory Committee, WCDHB Board, and the Executive Management Team. 

The Inequalities Training package also covers topics such as

• Determinants of Health
• Introduction to Health Inequalities
• Reducing Inequalities in Health
• Using the Health Equity Assessment Tool

The package explores the reasons that inequalities in health outcomes occur and educates people in the use of the inequality lens and the Health Equity Assessment Tool (HEAT) Tool in a way that they can apply it to their work. Another objective of this training is to raise the awareness of West Coast populations experiencing inequalities in health outcomes, and how to reduce inequalities for these populations.

Te Awatea / Cultural Awareness Training Programme

The Te Awatea / Cultural Awareness Training Programme is a mandatory cultural awareness programme specifically designed to meet the needs of Social Workers, Fieldworkers, and Home-Based Support Workers within the WCDHB. The first training programme was introduced to the Social Work Department in April 2006.

The intention of this programme is to ensure that these staff members have some cultural awareness and feel safe and confident when working with Māori clients and their families.  Where cultural safety is not occurring, any issues identified will be addressed by developing specific programmes to target those areas. It is expected that approximately 200 staff members will have attended this programme by the end of 2006.

For further information about this training programme, please contact the:

Social Work Department
Supervising Social Worker
Social Work Department
Ph: 03-768-0499, Extn. 2825#

Clinical Training Agency (CTA) Funded Nursing Programmes

The Clinical Training Agency provides funding for Post-Entry Clinical Training (PECT) programmes.

CTA Funded Nursing Programmes Currently Offered

• Post Graduate Certificate in Nursing (Child & Family)
• Post Graduate Certificate in Child and Family Health Nursing
• Post Graduate Certificate in Health Science (Emergency Nursing)
• Post Graduate Certificate in Clinical Nursing (Trauma and Emergency)
• Post Graduate Certificate in Clinical Nursing (Palliative Care)
• Post Graduate Diploma in Health Services (Advanced Nursing) in Rural Health Care

Nursing Entry to Practice Programmes (NETP)

New Graduate programmes are offered in all DHBs around the country. The programme is jointly funded by the Ministry of Health and DHBs. The Clinical Training Agency (CTA) will fund $6,000 per graduate in a placement, to subsidise some of the DHBs estimated costs in offering the programme. It is intended to fund programme coordination, study day and development release for graduates and preceptors and support for workload sharing between preceptor and graduate.  There is also additional funding set aside to assist with the education delivery and establishment of the programme.

CTA Funded Mental Health Programmes

• Advanced Mental Health Nursing
• Allied Mental Health Practice
• Child and Youth
• Cognitive Behaviour Therapy
• Dual Diagnosis
• Forensic Mental Health
• Māori Mental Health
• New Graduate Mental Health Nursing

Scholarship Information

West Coast DHB Scholarship Information

West Coasters excited by a career in health are being encouraged to apply for seven West Coast DHB scholarships to aid them on their path to success. The West Coast DHB has established seven scholarships of $1500 each for students who are proposing to work towards a health professional qualification. Students who are part way through a course of study are also encouraged to apply.

Former Chief Executive Kevin Hague said the criteria for the scholarships were that students had to be working towards a health qualification and to be from the West Coast. Mr Hague said the DHB was interested in hearing from people undertaking any form of health training not just those interested in medical or nursing degrees.

“There are numerous careers in health such as physiotherapists, dieticians, doctors, nurses, amongst others.” He said students who were selected for the scholarships would not be bonded to the DHB, although he was hopeful they would seriously consider returning to work on the West Coast.

“These scholarships are about attracting young people to careers in health and about encouraging them back to the West Coast at the end of their training.” As part of the scholarship programme the DHB would also work with the selected candidates to find them summer holiday work within the organisation.

West Coasters already studying for health qualifications were encouraged to apply along with school leavers. If students in their final year of study agreed to come back and work for the DHB after finishing their course of study they could also qualify for a $5000 incentive payment.
Anyone interested in applying for a West Coast DHB scholarship should register their name via the following email:

For more information please contact

Bryan Jamieson
Community Liaison Officer
03 768 0499, Extn. 2665#
027 245 9595

The Māori Education Trust

The Māori Education Trust (MET) is financed from private bequeaths and trusts set up by individuals and businesses. A primary function of the Trust is to provide and administer scholarships in education for Māori students. In addition to MET funded awards, the trust is also funded to administer scholarships on behalf of the Ministry of Education and other agencies.

For more information visit the Māori Education Trust  website

at http://www.maorieducation.org.nz/sch/  regarding availability and criteria for the following scholarships:

• Secondary School Scholarships
• Under Graduate Scholarships
• Post Graduate Scholarships
• Manaaki Tauira (Grant)

Postal address:

Māori Education Trust
PO Box 11255
WELLINGTON 6142
Phone:(04) 499 8041
Fax:(04) 499 8006
Email:

Rata Te Awhina Trust

FREE SERVICE - Available to everyone

Youth Self Esteem Programmes

Working with individuals or groups encouraging them to “Take Action” by building their own self esteem and confidence. Acknowledging that positive skills and qualities contribute to developing a more positive attitude.

Attendance Officer / School Support

Promotion of regular attendance at school, conveying the importance of ensuring children have the best possible start in life. This worker goes into the school and supports students.

Aroha Ki Te Tangata

A programme designed to meet individual / group need that focuses on challenging behaviour, to initiate change, in a safe environment. This programme is court approved.

Budgeting

This service works closely with WINZ to assist people to manage within a budget.

Counselling

All types of counselling available, one on one, couples, group, and abuse counselling by qualified staff.

Whānau / Family Support

With a paramount focus on the child and the vision of “growing futures for whānau”, the aim is to assist them to function effectively and make decisions.

Parenting Programmes

Bag of tricks, Triple P (Positive Parenting Programmes). Working with parents on different methods and strategies in parenting toddler to teenager.

Mobile Māori Disease State Management (DSM)

Management, Support and Education of Chronic Diseases including Diabetes, Lung Disease, Heart Disease, Fasting Cholesterol Blood Sugar Testing, and Blood Pressure Monitoring. The DSM nurse works closely with GPs, hospitals, and other health professionals, and refers on as required.

Whānau Ora (West Coast Buller)

A whānau centre service with whānau supported to achieve maximum health and well-being. This includes assessment, general health education, and referrals as appropriate and necessary.

Promoting Health

Rata Te Awhina Trust are committed to promoting health at every opportunity to help reduce inequalities and work towards a HEALTHY COMMUNITY.

Te Waka Hauora

This Mobile Unit offers a wide range of FREE wellness checks aimed at early detection and prevention of cardio / respiratory diseases and other chronic illnesses including Diabetes. Look out for the advertisement in the weekly publication of The Messenger.

Tamariki Ora Support

Support for whānau to promote and encourage well child checks and general Tamariki well-being.

Tamariki Ora Well Child

Well child checks for Tamariki and referrals to other health professionals as required. This nurse liaises with Plunket and other well care providers to ensure best outcomes for whānau.

Mother & Pepi

To provide education support and advice to mothers during pregnancy, following birth and up until two years of age. This support is designed to generate a warm, therapeutic, non judgemental and culturally appropriate environment.

Community Education

Initiatives to reduce family violence and abuse on the West Coast including education.

TIKANGA
Best Practice Guidelines

How to use:
Click on any of the following links to expand and view all the content of this category. Click again to collapse it again.

• Introduction

This section summarises the approved West Coast DHB Tikanga Recommended Best Practice Guidelines policy that outlines key traditional principles of tikanga and recommends ways to encompass Māori values and beliefs into frontline service delivery.

It is noted that this document is not for all tribal affiliations and some iwi may have differing protocols.

The aim is to ensure the wairua (spiritual), hinengaro (psychological) and tinana (physical) wellbeing of Māori patient/clients (tūroro/tangata whaiora) and their whānau (family and extended family group) is upheld.

These guidelines can also be made available and delivered to all consumers of health care services regardless of ethnicity as they include best practice standards of care.

These guidelines apply to all West Coast DHB staff including contracted staff and apply to all West Coast DHB facilities.

• Karakia

Karakia (blessings, prayer, incantations)

For many Māori, karakia is essential in protecting and maintaining their spiritual, mental, emotional and physical health - particularly in a health-care setting.

Staff action:

Verbally offer the Māori patient and their whānau the choice of having karakia at all stages of the care process including heightened situations (e.g.: psychotic incidents) and pending death.

Support this by:

• Allowing time for karakia
• Not interrupting karakia unless the physical care of the patient is compromised.
• In extreme cases where karakia cannot occur, explain why in a sensitive manner and discuss possible options.
• Providing access to appropriate water and containers for the purpose of spiritual cleansing.
• Ensuring that Māori patients wishing to have karakia have access to the Māori Health Service Information pamphlet available in all wards.
• Māori patient or whānau member may request a minister or lay person of their choosing.
• Whānau Support

Family and extended family is of fundamental importance to Māori. The concept of family and friends extends beyond the nuclear of biological family concept. Whānau support can be crucial to the patient's wellbeing.

Staff action:

The Māori patient and their whānau should be actively encouraged, supported and included in all aspects of care and decision making.

Support this by:

• Sharing a copy of the care plan with the Māori patient and whānau
• Asking the patient and/or whānau if they wish to nominate a person to speak on behalf of the whānau
• Acknowledgement and involving the person nominated (if any)
• Including appropriate Māori staff (e.g.: Kaiawhina) in the care and decision making process, if this is agreed to by the patient and the whānau
• Where possible, finding private space and adequate time when consulting with whānau throughout the care process and checking with whānau about suitable meeting times and their needs
• Being flexible about visiting times and visitor numbers where possible
• Being supportive of whānau visiting when death is expected or imminent
• Information & Support

The aim is to provide health care in an environment that is culturally sensitive to those using it. This is done out of respect for different cultural perspectives and needs and also to support the total health (whaiora) of the person receiving health care.

Staff action:

Make sure the patient and their whānau understand what is happening, and what resources and support are available, including speakers of Te Reo Māori, patient advocates, Kaiawhina and Chaplains.

Support this by:

• Clearly introducing yourself and your role/service
• Ensuring that all information is given clearly and is understood by the patient and/or their whānau.
• Understanding that for Māori the concept of "next of kin" may be broadly interpreted at registration
• Notifying appropriate Māori staff of the patient in their care as soon as possible (e.g.: on admission/referral)
• Offering an interpreter where appropriate
• Ensuring the patient and whānau are aware of the available West Coast DHB accommodation services preferably prior to admission
• Keeping an up-to-date list of resources that are available (e.g.: patient advocacy services, whānau rooms and other dedicated spaces, Māori chaplain, external Māori providers and support services) and informing the patient and their whānau about these
• Ensuring that the patient and whānau have access to Māori Health Service Information pamphlets which are available in all wards
• Food/Linen/Bedpans

Tapu and noa are key concepts that underpin many practices. For example, it is important to keep things that are tapu (sacred) separate from things that are noa (not-sacred). In many cases, these align with good health and safety procedures that should be practised by staff.

Staff action:

Become familiar with the basic principles of tapu and noa, and practical ways of respecting these concepts.

Support this by:

• Not passing food over a person's head
• Not using pillowcases for any other purpose, supporting whānau if they bring their own pillowcases
• Using different flannels for washing the head and washing the body - where possible use different coloured flannels to differentiate
• Washing the body in a strict order starting from the neck to genital and then anal area
• Keeping separate from food anything that comes into contact with the body or body fluids, for example:
  • Combs and brushes should not be placed on a surface where food is placed
  • Don't sit on the tables or workbenches, particularly surfaces that are used for food or medication
  • Microwaves used for heating food will not be used for heating anything that has come into contact with the body
  • Fridges or freezers used for food or medication storage should not be used for any other purpose
  • Receptacles used for drinking water should be used solely for this purpose
  • Tea towels will only be used for drying dishes and will be washed separately from all other soiled linen
  • Bedpans/urinals and food will not be present at the same time
  • Bedpans/urinals must be placed on the correct equipment (not where food trays are placed) and always stored in their own designated area
• Taonga/Valuables

Taonga are extremely important to Māori and have much more significance than just sentimental value.

Staff action:

Be aware and respectful of taonga and discuss any need to handle taonga with the patient and/or their whānau.

Support this by:

• Where possible, securely tape Taonga to the body of the patient rather than removing it
• If risk is involved, obtaining the consent of the patient before removing Taonga
• Giving the patient or their whānau the option of removing it themselves
• Giving the whānau the option of caring for any Taonga
• Informing the patient and whānau of the risk of storing Taonga and how it will be stored (in the identified valuables safe, where provided)
• Whānau rooms and designated areas

Some areas will be governed by Māori protocol and Tikanga Māori should be observed by all staff and other people using the facility. e.g.:

• Area designated as a whānau room for specific purposes
• Area or room used for whānau group conferences
• DHB Boardroom and other service facilities where pōwhiri ceremonies are conducted
• Rooms where a Māori death has taken place
• Chapel or viewing room when it is occupied by the tūpāpaku

Staff action:

Staff must respect these areas set aside permanently or on occasion. All staff are made aware of appropriate Māori protocol at their orientation.

• Body parts/Tissue/Substances

Staff action:

As with any patient, the correct process should be followed in communicating fully with the patient about the procedure, and consulting with the patient about options for removal, retention, return or disposal. Informed consent must be obtained where required.

In addition, staff should consider the following points where a Māori patient is concerned:

• Offering the option for further support from the appropriate Māori staff, e.g.: Kaiawhina. Where possible this must happen prior to any intervention.
• Returning of body parts/tissues/substances in a way that is consistent with Tikanga and in consultation with appropriate Māori staff. For esample, body parts/tissue/substances should be returned in containers that are durable and reflect tikanga best practices.
• Recording and carrying out the wishes of the Māori patient and/or whānau if the original purpose of retention changes. Returns should follow Tikanga best practices and protocols determined in consultation with Māori staff.
• Returning unconsented body parts/tissue/substances is expected to follow existing protocols. If return or retention is not requested, staff should discuss and agree to disposal and/or burial of the body parts/tissue/substances with the Māori patient and/or whānau. This should be carried out in a considered and consultative manner that respects tikanga processes.
• Document all discussions and decisions in the clinical notes.

Organ and Tissue Donation

Refer to West Coast DHB Tikanga Best Practice policy document.

• Pending and following death

As for any patient, family/whānau should be notified, supported and involved where the death of a patient is expected.

In addition, when a Māori patient is involved, staff should:

• Immediately notify support staff (e.g.: kaiawhina) involved in the care of the patient

Tūpāpaku (Deceased)

(Mandatory)

• Where possible, do not leave the body unattended following death. It is acknowledged this is generally not possible in a Coroner's Case
• Immediately notify Kaiawhina involved in the care of the patient
• Be guided by whānau on the cultural and spiritual practices for them at this time
• Give whānau the opportunity to perform cultural and spiritual rites for "karakia tuku I te wairua" before tūpāpaku is removed, and in particular before a post mortem
• A karakia should be performed in the area the patient died as soon as possible after the tūpāpaku is removed. From a Māori perspective the room is not spiritually cleansed until an appropriate karakia and cleansing with water has been performed
• Do not take food or drink into the room following death
• Where possible allow the whānau to take the tupapaka to a designated area, e.g.: viewing rooms or chapel
• Exiting of tūpāpaku to designated areas must avoid public corridors and food outlets
• Always transport the tūpāpaku feet first

To view/print the Tikanga Best Practice Guidelines please click here.

Related Information on this Site

Publications

Māori Health Plan (2007-2011)

Contacts

Selected WCDHB Māori Health Contacts

Māori Health Department Contacts

Facilities

Facility: Whānau/Family House - Whakaruru

Legend

The Legend of Poutini

Related Information on other Websites

Ministry of Health Website

Hē Korowai Ōranga; 2002 Māori Health Strategy

Whakatātaka: 2002 Māori Health Action Plan Te Kete Hauora, Māori Health Directorate of the Ministry of Health: About Māori Health

Māori Health Research

Māori Health Research

Ottawa Charter

Health Promotion Info: Ottawa Charter Framework

Māori Health Resources

Weka - Resources for Māori with Disabilities

Māori Language and Protocols

Learn more about Māori protocol